Taghipour Mehdi, Mena Esther, Kruse Matthew J, Sheikhbahaei Sara, Subramaniam Rathan M
aRussell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland bDepartment of Radiology cAdvanced Imaging Research Institute dDepartment of Clinical Sciences eDepartment of Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Nucl Med Commun. 2017 Mar;38(3):250-258. doi: 10.1097/MNM.0000000000000639.
To compare the accuracy of same-day therapy-assessment PET/computed tomography (PET/CT) and conventional contrast-enhanced computed tomography (CECT) in patients with oropharyngeal squamous cell carcinoma (OPSCC).
A total of 110 (95 men and 15 women; mean age 59 years) patients with biopsy-proven OPSCC were evaluated with same-day PET/CT and CECT pair scans as part of follow-up therapy assessment. Scans were performed within 6 months after the completion of primary treatment (median time: 3.1 months; range: 0.5-6 months). PET/CT and CECT scans were reviewed retrospectively for residual primary site disease, and right and left cervical lymph node involvement. Histopathology or 6 month clinical/imaging follow-up were used as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the primary site and cervical nodal disease.
Of 110 OPSCC patients, 90.9% were human papilloma virus positive, 80.8% were stage 4, and 76.4% received chemoradiation as the primary treatment. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT were similar in the evaluation of the primary cancer site (PET/CT: 75.0, 91.5, 25.0, 99.0, and 90.9, respectively, versus CECT: 75.0, 90.6, 23.1, 99.0, and 90.0, respectively). In evaluating cervical lymph node involvement, PET/CT appeared to have higher accuracy (96.8 vs. 81.7%), specificity (97.7 vs. 81.7%), and PPV (45.8 vs. 16.5%), comparable NPV (99.4% for both), and lower sensitivity (65 vs. 75%) compared with same-day CECT.
Same-day PET/CT and CECT scans had comparable accuracy in the evaluation of primary tumor sites after completion of therapy in patients with OPSCC. PET/CT showed higher accuracy in the evaluation of cervical lymph node involvement.
比较口咽鳞状细胞癌（OPSCC）患者当日治疗评估正电子发射断层扫描/计算机断层扫描（PET/CT）与传统增强计算机断层扫描（CECT）的准确性。
共有110例（95例男性和15例女性；平均年龄59岁）经活检证实为OPSCC的患者接受了当日PET/CT和CECT配对扫描，作为后续治疗评估的一部分。扫描在初次治疗完成后6个月内进行（中位时间：3.1个月；范围：0.5 - 6个月）。对PET/CT和CECT扫描进行回顾性分析，以评估原发部位残留疾病以及左右颈部淋巴结受累情况。组织病理学或6个月的临床/影像学随访被用作金标准。计算原发部位和颈部淋巴结疾病的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。
110例OPSCC患者中，90.9%为人乳头瘤病毒阳性，80.8%为4期，76.4%接受放化疗作为主要治疗方法。在评估原发癌部位时，PET/CT和CECT的敏感性、特异性、PPV、NPV和准确性相似（PET/CT分别为75.0、91.5、25.0、99.0和90.9，而CECT分别为75.0、90.6、23.1、99.0和90.0）。在评估颈部淋巴结受累情况时，与当日CECT相比，PET/CT似乎具有更高的准确性（96.8%对81.7%）、特异性（97.7%对81.7%）和PPV（45.8%对16.5%），NPV相当（两者均为99.4%），敏感性较低（65%对75%）。
在OPSCC患者治疗完成后，当日PET/CT和CECT扫描在评估原发肿瘤部位方面具有相当的准确性。PET/CT在评估颈部淋巴结受累情况时显示出更高的准确性。
